Bies Robert R, Mulsant Benoit H, Rosen Jules, Huber Kimberly A, Wilson Nicole L, Kirshner Margaret A, Pollock Bruce G
Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
Am J Geriatr Pharmacother. 2005 Jun;3(2):87-91. doi: 10.1016/j.amjopharm.2005.07.002.
This study was intended to compare the consistency of risperidone exposure in patients who have dementia and behavioral disturbances treated in a psychiatric hospital versus a community care setting.
Population pharmacokinetic modeling was used to assess the consistency of risperidone exposure in Alzheimer's disease patients with agitation. The ratio of predicted to observed drug concentrations (Cpred/Cobs) derived from this model was used to compare exposure in the inpatient versus long-term/home care settings using both the mean and the variance of this term across groups.
The modeled Cpred/Cobs ratios had a much higher within-subject variance in the inpatients than in the community care patients (117.03% vs 72.35%; P < 0.001). The central tendencies of the Cpred/Cobs ratios across the 2 groups were not significantly different.
Exposure to risperidone was more variable in a psychiatric hospital than in a community care setting. Future research may help to identify the specific contributors to the increased variance observed in this pilot study.
本研究旨在比较在精神病医院接受治疗的伴有行为障碍的痴呆患者与在社区护理环境中接受治疗的患者中利培酮暴露量的一致性。
采用群体药代动力学建模来评估伴有激越症状的阿尔茨海默病患者中利培酮暴露量的一致性。该模型得出的预测药物浓度与观察药物浓度之比（Cpred/Cobs）用于通过该比值在各群体中的均值和方差来比较住院患者与长期/家庭护理环境中的暴露量。
与社区护理患者相比，住院患者的模型Cpred/Cobs比值在个体内的方差要高得多（117.03%对72.35%；P<0.001）。两组的Cpred/Cobs比值的中心趋势无显著差异。
在精神病医院中利培酮的暴露量比在社区护理环境中更具变异性。未来的研究可能有助于确定在这项初步研究中观察到的方差增加的具体因素。
